20161210

20161211

20161212

6 Posts

Sialolithiasis is the formation or presence of a calculus inside the duct or parenchyma of salivary gland. The predisposing factors to calculus formation are salivary stagnation, trauma to salivary gland or duct, increased alkalinity of saliva, infection or inflammation of the salivary gland or duct.1 It is more common in submandibular gland as it’s saliva is more alkaline with increased concentration of calcium and phosphate and the mucous content is higher than the saliva of parotid and sublingual glands.
Sialolithiasis more commonly affects the adults of age group 30 to 60 years with male predilection. However study has been published that children of 3 weeks to 15 years of age were also affected.2
The complete obstruction to the flow of saliva secreted by the stimuli of food or infection of the gland causes pain and swelling of the involved gland.3
Case Report: A Female patient aged 37 years came to our clinic with a chief complaint of tooth ache in the right side of the lower jaw and swelling in the left side of the lower jaw and had difficulty and pain in turning the neck for the past 3 days . On inspection a diffuse swelling was present below the angle of mandible on the left side. The skin over the swelling is normal and pinchable and no sinus opening were present. On palpation the swelling is soft and tender. Intraoral examination reveals a decay tooth 48(right mandibular third molar),no decay tooth on left side no gingival and periodontal disease, dryness of mouth. She had no history of fever in recent times or trauma .No similar episode occurred earlier. She gave us a clue of frequent, self reducing, painless swelling which occurred 3 months back in the same place after having food. We advised the patient to have an OPG. OPG reveals the presence of a radiopaque mass near the lower border of the left angle of the mandible, decayed right mandibular third molar involving the pulp. CT revels presence of a calculus measuring 6.00mmx3.00mm in the left submandibular duct. The left submandiular gland appeared atrophied with fatty infiltration.

Hand, foot, and mouth disease (HFMD) is a viral disease occurring mainly in children under 5 years of age and is uncommon in immunocompetent adult. HFMD is caused by Enterovirus71(EV71) and Coxsackie virus A16 (CA16),A5,A7,A9,A10,B2,B5 .3It spreads through fecal-oral route, respiratory droplets3,4, horizontal transmission from mother to foetus. It is characterized by fever and herpetic lesions on the hands , feet and oral mucosa . This case is presented due to its rarity and to highlight it’s possible risk factors which can be avoided. Case Report
A 34 yr old man came with complaints of painful lesion over the fingers and legs for 2 days. There was history of fever two days before for which he took paracetamol. Patient also gave history of oral ulcers for past two days over the lips. There was no history of similar episodes before or trauma. No history of any other drug intake in the past month. No history of genital ulcers or any other skin lesion. Patient gives history of similar disease for his child for which he took treatment from a paediatrician. On clinical examination there were clear vesicles with an erythematous halo over the tip of fingers [Figure-1,2] and few scattered lesions over knee joint and sole [Figure-3]. There were multiple apthous like ulcers in the oralcavity [Figure-4]. No target or targetoid lesions seen. A differential diagnosis of erythema multiforme is thought because of fever, oral ulcer and skin lesion. Because of the presence of vesicles over the mouth, fingers and leg with a classical morphology and contact H/o a diagnosis Hand foot and mouth disease is made clinically. The patient was also checked for HIV and found to be negative.
Discussion
HFMD is an acute viral disease of children under 5 years of age. It is uncommon in immunocompetent adult. Due to its rarity even the physicians may get confused with herpetic infections. Since the disease is mild and asymptomatic in adult, they may not present themselves to the clinic and may serve as a potential reservoir. The possible risk factors contributing to this disease in adult are stress, fatique, having children under 5 years of age, having children diagnosed as HFMD, poor personal hygiene consciousness and sharing of mobile phones. Mobile phone serves as a reservoir of more number of pathogens.1 Teaching faculty and medical faculty are more susceptible to HFMD than any other faculty as they have more contact with children.2 Females are more susceptible to HFMD as they have more contact with children both at work and home as the childcare is usually provided by woman. HFMD in adult can be prevented by avoiding close contact such as kissing and cuddling with children diagnosed as having HFMD, avoid sharing of mobile phone , regular sterilization of mobile phone, maintaining proper personal hygiene.
Conclusion
HFMD in adult may increase in future due to the change in climatic conditions, increased global travel and continuous change in the evolution of virus. A thorough clinical examination and a throat swab or anal swab helps in definitive diagnosis.

Hand, foot, and mouth disease (HFMD) is a viral disease occurring mainly in children under 5 years of age and is uncommon in immunocompetent adult. HFMD is caused by Enterovirus71(EV71) and Coxsackie virus A16 (CA16),A5,A7,A9,A10,B2,B5 .3It spreads through fecal-oral route, respiratory droplets3,4, horizontal transmission from mother to foetus. It is characterized by fever and herpetic lesions on the hands , feet and oral mucosa . This case is presented due to its rarity and to highlight it’s possible risk factors which can be avoided. Case Report
A 34 yr old man came with complaints of painful lesion over the fingers and legs for 2 days. There was history of fever two days before for which he took paracetamol. Patient also gave history of oral ulcers for past two days over the lips. There was no history of similar episodes before or trauma. No history of any other drug intake in the past month. No history of genital ulcers or any other skin lesion. Patient gives history of similar disease for his child for which he took treatment from a paediatrician. On clinical examination there were clear vesicles with an erythematous halo over the tip of fingers [Figure-1,2] and few scattered lesions over knee joint and sole [Figure-3]. There were multiple apthous like ulcers in the oralcavity [Figure-4]. No target or targetoid lesions seen. A differential diagnosis of erythema multiforme is thought because of fever, oral ulcer and skin lesion. Because of the presence of vesicles over the mouth, fingers and leg with a classical morphology and contact H/o a diagnosis Hand foot and mouth disease is made clinically. The patient was also checked for HIV and found to be negative.
Discussion
HFMD is an acute viral disease of children under 5 years of age. It is uncommon in immunocompetent adult. Due to its rarity even the physicians may get confused with herpetic infections. Since the disease is mild and asymptomatic in adult, they may not present themselves to the clinic and may serve as a potential reservoir. The possible risk factors contributing to this disease in adult are stress, fatique, having children under 5 years of age, having children diagnosed as HFMD, poor personal hygiene consciousness and sharing of mobile phones. Mobile phone serves as a reservoir of more number of pathogens.1 Teaching faculty and medical faculty are more susceptible to HFMD than any other faculty as they have more contact with children.2 Females are more susceptible to HFMD as they have more contact with children both at work and home as the childcare is usually provided by woman. HFMD in adult can be prevented by avoiding close contact such as kissing and cuddling with children diagnosed as having HFMD, avoid sharing of mobile phone , regular sterilization of mobile phone, maintaining proper personal hygiene.
Conclusion
HFMD in adult may increase in future due to the change in climatic conditions, increased global travel and continuous change in the evolution of virus. A thorough clinical examination and a throat swab or anal swab helps in definitive diagnosis.

Hand, foot, and mouth disease (HFMD) is a viral disease occurring mainly in children under 5 years of age and is uncommon in immunocompetent adult. HFMD is caused by Enterovirus71(EV71) and Coxsackie virus A16 (CA16),A5,A7,A9,A10,B2,B5 .3It spreads through fecal-oral route, respiratory droplets3,4, horizontal transmission from mother to foetus. It is characterized by fever and herpetic lesions on the hands , feet and oral mucosa . This case is presented due to its rarity and to highlight it’s possible risk factors which can be avoided. Case Report
A 34 yr old man came with complaints of painful lesion over the fingers and legs for 2 days. There was history of fever two days before for which he took paracetamol. Patient also gave history of oral ulcers for past two days over the lips. There was no history of similar episodes before or trauma. No history of any other drug intake in the past month. No history of genital ulcers or any other skin lesion. Patient gives history of similar disease for his child for which he took treatment from a paediatrician. On clinical examination there were clear vesicles with an erythematous halo over the tip of fingers [Figure-1,2] and few scattered lesions over knee joint and sole [Figure-3]. There were multiple apthous like ulcers in the oralcavity [Figure-4]. No target or targetoid lesions seen. A differential diagnosis of erythema multiforme is thought because of fever, oral ulcer and skin lesion. Because of the presence of vesicles over the mouth, fingers and leg with a classical morphology and contact H/o a diagnosis Hand foot and mouth disease is made clinically. The patient was also checked for HIV and found to be negative.
Discussion
HFMD is an acute viral disease of children under 5 years of age. It is uncommon in immunocompetent adult. Due to its rarity even the physicians may get confused with herpetic infections. Since the disease is mild and asymptomatic in adult, they may not present themselves to the clinic and may serve as a potential reservoir. The possible risk factors contributing to this disease in adult are stress, fatique, having children under 5 years of age, having children diagnosed as HFMD, poor personal hygiene consciousness and sharing of mobile phones. Mobile phone serves as a reservoir of more number of pathogens.1 Teaching faculty and medical faculty are more susceptible to HFMD than any other faculty as they have more contact with children.2 Females are more susceptible to HFMD as they have more contact with children both at work and home as the childcare is usually provided by woman. HFMD in adult can be prevented by avoiding close contact such as kissing and cuddling with children diagnosed as having HFMD, avoid sharing of mobile phone , regular sterilization of mobile phone, maintaining proper personal hygiene.
Conclusion
HFMD in adult may increase in future due to the change in climatic conditions, increased global travel and continuous change in the evolution of virus. A thorough clinical examination and a throat swab or anal swab helps in definitive diagnosis.